MENTOR-MARYLAND

FREDERICK, MD
NPI1104352368
Entity TypeOrganization
Authorized ContactCAROL IVY SIMMONS
Director, Omhc
410-455-4600
Organization Subpart ?No
Primary Taxonomy251S00000X 
(Licence: MD  MH-2279)
Enumeration Date2017-05-10
Last Update Date2017-05-10
Business Address
MENTOR-MARYLAND
5970 FREDERICK CROSSING LANE #202
FREDERICK, MD 21704
Phone number: 301-524-0977
Mailing Address
MENTOR-MARYLAND
5720 EXECUTIVE DRIVE
CATONSVILLE, MD 21228
Phone number: 410-455-4600
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